This article is an opinion editorial by Jackie Clark, PhD, Douglas L. Beck AuD, and Walter Kutz, MD.

Ear candles are hollow tapered cones made of cloth and soaked in beeswax or paraffin; the narrow funnel is placed into the ear and the opposite side of the cone is ignited in flame. Upon reading the previous sentence, many people will immediately say, “you’re kidding?” Clearly, ear candling is not reasonable, rational, safe, or effective, and indeed, it should simply never be done.

When one “googles” the term “ear candling,” 673,000 Web sites and links appear. Many present reasonable and rational information warning those contemplating this activity of nonexistent benefits in tandem with significant potential for serious injury. The medical literature has clearly demonstrated ear candling has often caused serious injury without evidence of benefit (Zackaria and Aymat, 2009).

Nonetheless, many Web sites, retailers, and “practitioners” continue to offer a variety of candling products with claims of homeopathic and/or natural healing through the practice of ear candling. The widespread hype supporting ear candling (also known as ear coning) refers to ancient Egyptians, Mayans, and Tibetans as having practiced candling. Practitioners of ear candling often make unsubstantiated claims of the effectiveness of ear candling in treating a multitude of problems. Some typical claims include removal of cerumen (ear wax), reduction of sinus pressure, treatment of allergies, treatment of hearing loss, sharpening the senses of smell, taste and color perception, relief of temporomandibular joint (TMJ) pain, and the treatment of vertigo, etc. Proponents of ear candling claim oxygen is drawn from the flame, thus producing a vacuum that literally pulls residue out of the ear. Many proponents further claim the vacuum affects and drains all passages of the head via the tympanic membrane (ear drum).

Therefore, we offer this discussion in a simple question and answer (Q&A) format. Further, we recommend before anyone undertake ear candling, they should discuss the matter with a licensed physician, audiologist, or hearing aid dispenser. The bottom line is ear candling is ineffective and potentially dangerous and we do not recommend it at any time for any reason.

Claim 1: Interconnections in the head allows the candles to drain the entire system through the ear.

FALSE: Liquids and gases cannot pass through a normal healthy ear drum. For example, most people have experienced pressure in their ears when changing altitude while driving in mountains, or ascending or descending during flight. This pressure sensation results from atmospheric pressure changes acting on the middle ear space. If liquids and gases could readily pass through the ear drum, changes in atmospheric pressure would not create a “change in pressure” sensation. And, by the way, there are no empty interconnecting passages. Yes, there are arteries, veins, lymph systems, and neural networks, but they have very specific ongoing functions that cannot be impinged upon while mysterious things are allegedly drained through solid barriers!

Claim 2: Oxygen drawn through the candle will create a vacuum.

FALSE: A basic scientific evaluation measured the amount of vacuum force created by ear candles when placed in a simulated human ear canal. Despite numerous trials, this presumed phenomena (creation of a vacuum) simply did not occur at any point during the trials (Seely, Quigley, Langman, 1996; Kaushall and Kaushall, 2000).

Claim 3. When a vacuum is created, it will pull residue out from the ear canal.

FALSE: A scientific study compared individuals’ ear canals before and after candling. Some subjects had impacted earwax and others had completely clear ear canals prior to candling. In all instances, after candling, there was no reduction in the amount of ear wax found in individual’s ear canals. In fact, after candling, some participants had candle wax deposited in their ear canals. Indeed, meticulous analysis of the contents in the ear candle after use (using gas chromatography) showed multiple alkanes of candle wax, with no constituents of cerumen (Seely, Quigley, Langman, 1996). If anything, individuals subjected to ear candling have complained about significant pain from the heat funneled into the ear and very loud “bubbling” noises created from the candle.

Claim 4. The method is safe, noninvasive, and effective.

FALSE: Candling is dangerous. Survey responses from medical specialists (otolaryngologists) in the United Kingdom reported ear injuries from ear candling including; burns, ear canal occlusions and ear drum perforations and secondary ear canal infections with temporary hearing loss (Seely, Quigley, Langman, 1996). In some patients, multiple complications were found. There have been reports within the United States demonstrating ash remnants and residue from ear candling coating the eardrum (Kutz and Fayad, 2008). Additionally, significant fires associated with ear candling have been reported, one of which led to the user’s death (Powell, 2005). In recent years Health Canada’s Medical Device Regulatory Agency declared that selling ear candles requires a license from Health Canada before anyone can sell them for therapeutic purposes. Yet, Health Canada has not issued any licenses for ear candles, consequently selling ear candles for “therapeutic purposes” in Canada is illegal. The U.S. FDA and Health Canada have acted against manufacturers of ear candles by providing alerts to consumers not to use ear candles, seizing products, and issuing bans for importing ear candles. Despite the proactive stance of these government agencies, there are hundreds (perhaps thousands) of “practitioners” around the United States ready to perform the procedure (see multiple FDA references, below).

Summary

Ear candling is dangerous (even when used as directed by the manufacturer) and serves no legitimate purpose and there is no scientific evidence showing effectiveness for use. It is of significant concern that some ear candles are advertised for use with children (including babies), potentially placing them at great risk—with no known or documented benefit.

As hearing professionals and doctors, we strongly recommend prior to undertaking ear candling, consumers and patients are urged to discuss the matter with their physician, audiologist, or hearing aid dispenser. Bottom line: Ear candling is ineffective and potentially dangerous and we do not recommend it at any time for any reason.

Jackie Clark, PhD, is a clinical associate professor at the School of Behavioral and Brain Sciences, UT Dallas. She is also a research scholar at the U. Witwatersrand, Johannesburg, South Africa.

Douglas L. Beck, AuD, is the Web content editor with the American Academy of Audiology.

Walter Kutz, MD, assistant professor, Department of Otolaryngology, at the University of Texas Southwestern Medical Center.

References and Recommendations

Ear Candles: Risk of Serious Injuries February 20, 2010

www.fda.gov/MedWatch/report.htm

www.fda.gov/Safety/MedWatch/SafetyInformation/default.htm

www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm201108.htm

Powell GL. E-mail to Dr. Stephen Barrett, April 15, 2005 as reported: http://www.quackwatch.org/01QuackeryRelatedTopics/candling.html 21-Apr-10.

Kaushall P, Kaushall JN. (2000) On ear cones and candles. Skeptical Inquirer Sept/Oct:12.

Kutz W, Fayad JN. (2000) Ear candling. ENT Journal 87(9):499.

Seely DR, Quigley SM, Langman AW. (1996) Ear candles – Efficacy and safety. Laryngoscope 106: 1226–1229.

Zakaria M, Aymat A. (2009) Ear Candling: A Case Report. Eur J Gen Pract 15(3):168–169.

(ARA) - Hearing loss isn’t a harmless condition to be ignored. In fact, hearing loss often coexists with other serious health problems. And a growing body of research indicates that there may be a link. Studies show that people with heart disease, diabetes, chronic kidney disease, Alzheimer’s disease, and depression may all have an increased risk of hearing loss.

When left untreated, hearing loss alone can lead to a wide range of physical and emotional conditions. Impaired memory and the impaired ability to learn new tasks, reduced alertness, increased risk to personal safety, irritability, negativism, anger, fatigue, tension and stress are among its more common side effects. But when untreated hearing loss coexists with a chronic illness, the likelihood is all the greater that the individual will experience exacerbated levels of stress and diminished quality of life.

Here’s the good news: Research also indicates that professionally fitted hearing aids can help improve quality of life for people with chronic diseases when hearing loss does coexist.

“In the vast majority of cases, hearing loss can be addressed with hearing aids to help people hear better and improve their quality of life,” says Dr. Sergei Kochkin, executive director of the Better Hearing Institute (BHI).  “I strongly urge anyone with heart disease, diabetes, chronic kidney disease, Alzheimer’s, and/or depression to talk with their doctor and make hearing screenings a routine part of their medical care.”

BHI encourages people to take a free, quick, and confidential online hearing test at www.hearingcheck.org to determine if they need a comprehensive hearing check by a hearing professional. For more information on hearing loss, visit www.betterhearing.org.

The link between hearing loss and certain chronic diseases

Numerous studies have long linked untreated hearing loss to diminished psychological and overall health. But an emerging body of research is now revealing a link between hearing loss and other chronic health conditions.

For example, hearing loss is about twice as common in adults with diabetes compared to those who do not have the disease, according to a study funded by the National Institutes of Health (NIH) and published in the Annals of Internal Medicine.

Another study, published in the American Journal of Kidney Diseases found that older adults with moderate chronic kidney disease (CKD) have a higher prevalence of hearing loss than those of the same age without CKD.

Other studies have shown that a significantly higher percentage of people with Alzheimer's disease may have hearing loss than their normally aging peers. In fact, older adults with hearing loss appear more likely to develop dementia, and their risk increases as hearing loss becomes more severe, according to a study published in the Archives of Neurology,. The researchers also found that the risk of developing Alzheimer's disease specifically increased with hearing loss.

The link between unaddressed hearing loss and depression also is compelling. An Italian study found that working adults aged 35 to 55 who were affected by mild to moderate hearing loss in both ears reported higher levels of disability and psychological distress — and lower levels of social functioning — than a well-matched normal control population.

Perhaps the link between cardiovascular disease and hearing loss is the most widely recognized. In a study published in the June 2010 issue of the American Journal of Audiology, the authors reviewed research that had been conducted over the past 60 plus years. They found that the negative influence of impaired cardiovascular health on both the peripheral and central auditory system, and the potential positive influence of improved cardiovascular health on these same systems, was found through a sizable body of research.

“With so much evidence emerging on the potential link between hearing loss and various chronic illnesses, it becomes all the more pressing for people to identify and address hearing loss early on,” Kochkin says. “Talk to your doctor. Get your hearing checked. And be assured that in most cases, today’s state-of-the-art hearing aids, programmed to the specific hearing requirements of the individual, can help people hear better and thereby regain quality of life.”